The use of telemedicine to deliver remote speech-language pathology (SLP) services has been shown to be equivalent to face-to-face service delivery. However, existing technology limits the interaction a clinician can have with a remote client. The goal of this project is to develop and evaluate a videoconference-based telehealth system that will allow a wide range of interactive SLP therapeutic interventions to be delivered to remote clients. The hypothesis is that by developing a telehealth system that extends the capabilities of existing videoconferencing equipment a wider range of interactive SLP therapeutic interventions can be delivered to clients with speech, language, and/or cognitive-communication impairments. This project is developed around two specific aims which represent the primary stages of work: 1. The first aim is to develop a telehealth system that expands the interaction of traditional videoconferencing functionality to deliver a range of clinically relevant and appropriate SLP assessment and treatment material. Based on a user-centered approach, our collaborative team of engineers, SLP clinicians, and an Assistive Technology specialist will design the system to meet a pre- defined set of design goals and specifications. 2. The second aim is to evaluate the system through usability testing with both SLP clinicians and clients. We will evaluate the system through two cycles of formal task-directed usability testing with both SLP clinicians and clients to collect both qualitative and quantitative information on the system. The purpose of the usability testing is to find and address usability problems with the system before it is developed into the final release version which will be evaluated in a subsequent efficacy study comparing outcomes from traditional face-to-face SLP with teleSLP. Public health relevance: This development project will result in a multi-functional telehealth tool that will broadly impact the field of telemedicine by allowing new techniques and methods to be delivered to remote clients. It will enable numerous clinical and research applications across a wide range of medical disciplines. Developed through a user-centered approach, it will have applicability to a broad range of clinicians and clients in both home-care and hub-spoke models of telemedicine service delivery. [unreadable] [unreadable] [unreadable]